Tag: aca

This week Republican Senators Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana, introduced a new healthcare bill aimed at repealing and replacing the Affordable Care Act known as Obamacare.

The Senate is expected to vote on the bill next week, as any repeal and replace bill must be completed and voted on by September 30 in order for it to pass with only a simple majority of 51 votes.

Gets rid of the federal subsidies to help pay insurance premiums for those that cannot afford them.

Combines the funds for the Medicaid expansion and insurance subsidies into large block grants given to each state to spend freely to improve healthcare in the state.

Funding in the form of federal block grants to states would continue until the year 2026, when funding would be cut off. Most harmed by this bill are those states that chose to implement the Medicaid expansion through the ACA. States that did not do this would see a large influx of cash through the federal block grants in the bill.

Because of the short time frame to vote on the bill the Congressional Budget Office will not be able to provide a full analysis of how this will affect coverage for Americans, though the CBO did say it would release a limited analysis early next week.

Last week Senate Republicans released a new version of the Better Care Reconciliation Act, their repeal and replace bill, but were unable to corral enough support to bring the bill to the floor for a vote.

Republicans have now returned to an earlier plan to repeal the ACA first, with a two-year waiting period for implementation during which time they will continue to work on new healthcare legislation.

However, it is not known if a measure like this would pass either. Republicans passed a bill like it in the past, during the Barack Obama presidency when Republicans knew it would be vetoed. President Donald Trump would likely sign any bill that would repeal the ACA.

As this activity in Washington continues, all of us at ClaimLinx want to reassure our clients that we are prepared to adapt to any new healthcare bill and its resulting effects on the insurance market.

President Barack Obama halted speculation this week when he nominated Merrick Garland, chief justice of the U.S. court of appeals for the District of Columbia, to fill the vacant seat on the Supreme Court left by Antonin Scalia.

The drama surrounding the decision to fill the office rages on though, as members of the Senate must now decide if they will confirm the nomination or leave the seat vacant until the next president is elected.

At stake during this time of turmoil are a number of cases waiting to be heard and those already awaiting decision, including three cases concerning the future of healthcare. With only eight members of the high court left, there is an opportunity for a 4-4 split of the justices’ votes.

In the event of a split, the decision of the lower court is upheld, and the case is not deemed to have set any sort of precedent. The power of the Supreme Court as a final word and decision is effectively diluted.

Senate Majority Leader Mitch McConnell has already pledged that he will not confirm, or meet with, any nomination from Obama in an effort to involve the American people in the decision.

“The American people may well elect a president who decides to nominate Judge Garland for consideration,” he said on the Senate floor. “The next president may also nominate somebody very different. Either way, our view is this: Give the people a voice filling the vacancy.”

Garland, who was confirmed in his current position by a majority of both Democrats and Republicans, is seen as a moderate politically.

He has already been involved in a number of healthcare-related cases, sometimes siding with hospitals and sometimes siding with the Department of Health and Human Services.

“The nominee that was selected is probable the exact type of nominee most moderate Americans would want – somebody that is in the middle of the political spectrum and is extremely qualified,” Stewart Verdery, the founder of the Monument Policy Group, said to the Wall Street Journal.

Democrats in Congress demand members of the GOP fulfill their duty and consider the nomination, but it is unlikely a decision be made until the results of the presidential election.

In the meantime, the remaining Supreme Court justices will hear arguments next week in the case of Little Sisters of the Poor Home for the Aged v. Burwell, regarding non-profit companies’ obligation to provide birth control at no cost to employees. A decision is expected in June.

The sweeping $1.1 trillion spending bill that passed this month included three relatively modest changes to the Affordable Care Act. But both supporters and opponents of the law see them as momentous symbols of more permanent, potentially costly, changes to come.

The bill included a two-year delay on the law’s “Cadillac tax” on high-value health plans, a two-year suspension of the tax on medical devices and a one-year moratorium on a tax levied on all private health insurance.

The most significant of these changes by far is the delay to the “Cadillac tax,” currently scheduled to start in 2018. The provision was designed to reign in high priced insurance policies and the unnecessary health care spending they encourage.

The two-year delay means the government will miss out on about $3 billion in revenue in 2018 and $6 billion in 2019, according to a recent Congressional Budget Office analysis.

But for most, the short-term price tag is not the primary concern, but rather the long-term change it may forecast.

“The big concern with the delay is, it’s not a delay, it becomes a rolling permanent deferral,” said Peter Orszag, an economist who was President Barack Obama’s first director of the Office of Management and Budget.

Opponents of the tax, however, say it only encourages employers to decrease workers’ vital benefits packages.

According to the Kaiser Family Foundation’s recent analysis, about 1 in 4 employers are expected to offer health plans that would incur the Cadillac tax in 2018, but this figure is expected to increase significantly in coming years, as it is tied to insurance premiums as they relate to the rate of inflation. Insurance premiums have been growing more rapidly than that rate for many years.

The analysis shows that about 30 percent of employers will be affected by the tax by 2023 and about 42 percent five years after that, if their health plans remain the same and health costs continue upward at the same pace.

At that point, the tax’s revenue would balloon to an estimated $91 billion by 2025, according to the congressional Joint Committee on Taxation.

Significant potential revenue loss is likewise predicted to accompany the postponement of the tax on medical devices and private health insurance.

Freezing the medical device tax is estimated to cost the government about $1.4 billion in 2016 and $2 billion in 2017, according to another Congressional Budget Office analysis.

Opponents of the tax say it discourages the development and sales of innovative, lifesaving medical technology, therefore stunting the country’s growth in the field of medical research.

The tax on health insurers was expected to raise as much as $12 billion in 2017, according to the same analysis. But the tax’s challengers assert this is a small price to pay to protect the American consumer, who shoulders this tax through insurance premium increases.

Overall, these alterations to the Affordable Care Act are not anticipated to have a large impact on Washington revenue in the immediate future, but they could be first signs of permanent changes to come.

Many Republicans are still in favor of repealing the law or implementing broader cuts to its regulations.

Previous episodes have covered topics such as deciphering the difference between benefits and insurance. Listen to the entire show, during which Tom said:

“Insurance should take away catastrophic risks that owners don’t want to take on. And also, with the new Affordable Care, preventative risks and all the benefits within the health insurance plan must cover the ten essential benefits with no limits.”

“Why are you offering benefits? And if the answer is to provide better benefits than the competition and take care of your employees, why would, every year when the broker comes out, would you go from paying $10,000 a month to $11,000 a month? And it would have been $13,000 a month but you decided to raise the deductible from $1,000 to $2,000 and your copays go from $25 to $35. Why do you keep doing the same thing over and over again? Owners, you have to step up to the plate, get involved. This is an owners’ decision, with a CFO, CPA or tax attorney who understands the new Affordable Care Act. It is a huge opportunity for business owners to provide better benefits at a fraction of the cost.”

“Health insurance wasn’t a top ten expense 20 years ago. It has become, in some cases, a top three expense for companies. The problem is the owners need to be involved in every aspect of their business, when it comes to their balance sheet and the top three expenses. What they’ve done is they’ve allowed people within their company to make the decision and it’s becoming a major, major headache not only for the owner, but also for the employees. The decisions made with the new tax law called the Affordable Care Act are some of the worst decisions I’ve seen in the last twenty years in this business.”

“There’s a problem in this country starting in Jr. High. They should be teaching these kids about finance and insurance and things that they need to know. Because you have people running around this country who don’t understand that buying a $20 copay from an insurance carrier makes absolutely no sense. It would be like buying oil change insurance for your car or plumber’s insurance for your home … and it boils down to education.”